The Measurement and Prediction of Physical Functioning after Trauma

Trauma patients are at risk of developing remaining disability and complaints due to the injuries. These complaints importantly influence quality of life and patients’ ability to perform daily activities. It is important to be able to adequately assess (recovery of) physical functioning after trauma. Traditionally this was estimated physicians using X-ray imaging and the limitations in range of motion of affected joints. In his thesis, De Graaf evaluated whether physical functioning of trauma patients can be assessed using the Dutch Short Musculoskeletal Function Assessment (SMFA-NL) questionnaire.
The research showed that the SMFA-NL questionnaire is best used using four subscales (functioning of the arms, legs, daily activities and mental and emotional problems), instead of the two subscales that have traditionally been used for scoring the questionnaire. The four subscales were considered appropriate to correctly assess (reliable, valid and responsive) physical functioning at one moment in time, as well as to be able to assess change in physical functioning over time. To make the scores of the SMFA-NL better understandable, normative data of the Dutch population were obtained. Furthermore, it was investigated which change in score reflects relevant change in physical functioning to patients that sustained an injury. Finally, De Graaf and colleagues developed a prognostic model that can be used to predict 6 weeks after trauma, whether patients’ physical functioning will be completely recovered after one year. According to De Graaf, the SMFA-NL is an appropriate instrument to assess and follow-up physical functioning of individual trauma patients in a clinical setting. The SMFA-NL may also be used in scientific research to evaluate different treatments in patients that sustained an injury.